Cannabis Drug Interactions – Marijuana Mommy ®

Does Cannabis Interact with Antibiotics?

Jessie Gill — Fri, 27 Apr 2018 19:12:09 +0000

YES, Cannabis Does Interact With Some Medications

I often hear a list of questions from patients who want to know if they can use cannabis while taking antibiotics. “Is it safe to smoke marijuana when I’m on other medicines,” they ask. “Will cannabis affect my antibiotics? Will my antibiotics work if I use CBD oil?”

It’s good to be concerned, because yes, medication interactions CAN occur with cannabis. For example, cannabis and some antidepressants can interact. (And yes, the risk of drug interactions also applies to hemp-based CBD oil.) There CAN be interactions between cannabis and some antibiotics, specifically macrolide antibiotics like clarithromycin and erythromycin.

How Do I Know If I’m at Risk for an Interaction?

Patients should look up the specific medication they’re consuming to see if it uses the metabolic pathway CYP450. If it does utilize CYP450, then there is a risk of cannabis drug interactions.

Fortunately, most people do not experience a significant interaction when even when combining cannabis with macrolide antibiotics. Additionally, interactions are usually dose dependent, so the higher dose of cannabis you consume, the greater the risk.

Still because interactions are possible, consumers should be aware of what could happen…

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Interactions Between Marijuana & Antibiotics

As far as we know, cannabis does not reduce the effectiveness of antibiotics. (Incidentally, cannabis actually has antibacterial properties as well.)

However, because cannabis can increase the blood levels of some medicines, it can also increase the risk of side-effects. For most people this increase is not significant, but for some it can be.

It has a genetic component and so effects vary from person-to-person. Maybe your best friend, Sue, didn’t have an issue, but that doesn’t necessarily mean the same will hold true for you.

The thing is, Cytochrome P450 (CYP450) differs genetically, so you and Sue might have different genetic expressions. Which means medications might be processed differently and thus result in different reactions.

Cytochrome CYP450

Cytochrome P450 is the metabolic pathway in the liver that metabolizes cannabinoids. This is the same metabolic pathway many medications (including some some antibiotics).

Taking More Than One Medication Can Cause the Same Issue

It should be noted that medication interactions due to the CYP450 pathway are common. Every day, patients are prescribed numerous medications that all utilize the same pathway without consideration of overtaxing the system. The use of multiple prescription medications can present the same issues as combining marijuana with prescription medication.

Conclusion

Yes, cannabis can interact with some antibiotics, but usually, it’s insignificant. There’s no documented evidence of a dangerous drug interaction. However using cannabis may increase the risk of side effects from some medications (and that can be unpleasant and theoretically dangerous). As far as we know, cannabis does not decrease the effectiveness of antibiotics and research suggests it may act as an antibiotic itself.

Patients who choose to combine marijuana and antibiotics should be aware of the potential side-effects of all medications prescribed. As always, medication use, including medical marijuana, should be discussed with your licensed healthcare provider.

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Here’s how I answered this question on Quora:

Is it considered dangerous to smoke weed while on antibiotics?

Have you ever heard the warnings not to mix grapefruit juice and when taking some medications?

For example, when a patient is taking some cholesterol medications they are advised NOT to drink grapefruit juice. This is because grapefruit juice increases the level of the medication. For some medications, like blood thinner warfarin, this can be dangerous.

So you’re smart to be concerned. Marijuana is a medication, after all, and one should always use caution when mixing medications.

The truth is, we can’t say for certain. We haven’t been able to research weed since 1937, so a lot of these questions are still waiting to be answered.

Clinically, I haven’t read of any case studies of an antibiotic interaction, however, this is what you need to know.

Marijuana inhibits a specific enzyme in the liver, cytochrome p450. This enzyme is used by many medications – including some antibiotics.

So – using some macrolide antibiotics, (including troleandomycin, erythromycins, josamycin, flurithromycin, roxithromycin, clarithromycin, miocamycin, and midecamycin) could potentially interact with marijuana.

What this means is that the effect of the medications will be increased. That also means you’d be at a higher risk of experiencing side effects and adverse reactions from the antibiotics.

Intestinal issues and cardiac side effects have been noted with some macrolide antibiotics. It should be noted that there’s research suggesting marijuana might impact the heart as well.

Guess what else affects CP450? Grapefruit juice.

Grapefruit juice isn’t bad. It just needs to be used with caution. If someone won’t give up their grapefruit juice, the doctor needs to monitor their blood levels a little more closely. The same should be done with marijuana.

Always use caution when mixing meds.

Sweetest regards,

Jessie Gill, RN

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What Happens When You Mix Zoloft and Cannabis?

Jessie Gill — Thu, 26 Jan 2017 02:14:09 +0000

Is it safe to use Zoloft and weed?

Cannabis as Medicine

Cannabis is being used to treat a variety of health issues, from PTSD to Alzheimer’s disease to chronic pain to inflammation to cancer to migraines to concussive traumatic encephalopathy (CTE).

For most patients, marijuana is safer than other pharmaceuticals.

Still, it’s important to note, in some patients, marijuana can and does affect the absorption rates of some prescription medications. Much in the same way that grapefruit juice does.

Cannabis can interact with prescription medications by utilizing the metabolic pathway Cytochrome P450 in the liver & intestines.

Can Zoloft Interact With Marijuana?

Although rare, drug interactions are possible with Zoloft and marijuana.

Patients taking Zoloft (or other antidepressants) should use caution with cannabis.

Could Cannabis Be as Dangerous as Grapefruit?

Drug interactions are rare, but in theory, marijuana may be as dangerous as grapefruit.

(Note: Patients many prescription medications should also use caution with grapefruit.)

Patients are frequently warned about consuming grapefruit with some medications. The metabolism of some cannabinoids is similar to grapefruit.

What happens when you combine antidepressants and marijuana?

Mixing Zoloft and weed can result in a higher amount of Zoloft in your blood (so can mixing Zoloft and grapefruit juice). This is essentially equivalent to taking a higher dose of medication.

Does It Increase the Risk of Side-Effects?

Higher levels of medication can increase the risk of experiencing negative side-effects.

Most patients don’t experience a noticeable interaction, however, there are plenty of anecdotal reports of negative side effects from combining Zoloft and marijuana.

Reported symptoms include severe panic attacks.

No interactions have been observed in a clinical setting, but patients report temporary symptoms that eventually subside. This interaction can be a scary experience for the patient.

Also, keep in mind that smoking weed vs eating edibles can produce a different physiological experience.

If you’re making edibles, try these single serving edibles, first.

Mixing Zoloft and weed occasionally results in an adverse reaction.

What Patients Should Know About Mixing Zoloft with Marijuana

No Clinical Evidence, But Some Reports

There is NO research or clinical evidence that a drug interaction with marijuana can be deadly. However, caution should be utilized.

It needs to be noted that high levels of Zoloft in the blood can cause serotonin syndrome. Serotonin syndrome is a side effect of many antidepressants and is easily treated. However, it can be fatal when left untreated.

What If You Mix Cannabis And Anti-Depressants?

If you’re a patient on antidepressants, learn about the side effects of your prescription medication. Understand, that reactions between cannabis and antidepressants have been reported.

Talk to your doctor about your marijuana status (you may require a lower dose of antidepressants).

Marijuana might be as dangerous as grapefruit, but it’s not as deadly as alcohol or nutmeg (seriously, nutmeg is potentially deadly!)

READ: 25+ Unique Marijuana Pipes on Amazon.

How Grapefruit Affects Prescription Medication

It’s not uncommon to see a warning on a prescription bottle instructing the patient to avoid grapefruit juice while taking a medication.

Nurses commonly guide warfarin patients to avoid sudden changes in the amount of leafy greens they consume. And doctors profess that mixing alcohol with painkillers can be fatal.

Asking about marijuana and drug interactions is smart.

Different foods, drinks, and chemicals we put into our body can change the way our body works. So if drinking grapefruit juice can be fatal with some medications, what about weed? Can marijuana affect prescription medications?

Of course, it’s possible.

READ: Recipe for ABV Coconut Oil

How Cytochrome P450 Metabolism Works

Imagine your body is a cherry tree.

Imagine for a moment that the Zoloft molecules are cherries. You take a Zoloft pill, it splits into thousands of cherries and they start floating around in your blood.

Cytochrome P450

Well, your liver and intestines have special “cherry pickers”. These cherry pickers are called Cytochrome P450. Cytochrome P450’s job is to collect the cherries and convert them into something the body can use & dispose of.

But in order for a medication like Zoloft (and lots of other antidepressants) to be effective, the proper levels of medication need to accumulate at a specific concentration in the blood. Once the medication reaches the ideal concentration, the patients will see desired effects.

This is why doctors say it takes 4-8 weeks to notice a difference when beginning antidepressants. Ideal levels of Zoloft take time to build up in the blood.

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When Zoloft reaches the ideal level, the patient feels better (in theory).

As our CYP450 cherry pickers work as hard as they can, the balance of the cherries accumulates in our blood. When there are enough cherries in our blood, the medicine boosts serotonin levels in the brain which makes the patient feels better.

Medications like Zoloft need a constant & consistent level within the blood in order to work effectively.

The Challenge of Zoloft and Weed

The challenge arises when combinging some antidepressants, like Zoloft and weed because they both use the same “cherry pickers”.

Mara Gordon, founder of Zelda Therapeutics, explains, “the active components of medical marijuana, CBD especially, and to a lesser extent THC” also utilize pathway CYP450.

So, in some patients when they mix Zoloft and weed, the Zoloft molecules are not the only kind of cherry anymore. All of these molecules compete for the same cherry pickers.

Read: Project CBD – CBD Drug Interactions

So when you add weed and Zoloft together, you get a sudden influx of cherries in the blood! Yet, you have the same limited number of CYP450 cherry pickers.

Too Many Cherries

Cherry pickers can only work so hard and you’re already at a max.

In the end, the patient’s blood becomes inundated with unpicked cherries – many more cherries than your doctor had planned.

This means the blood level of the medication increases. This could be the equivalent of taking a higher dose of Zoloft than intended. This also means the blood levels of cannabinoids will be higher than expected.

Because antidepressants need consistency to function properly – taking both Zoloft and weed should be monitored by a doctor.

Marijuana & Drug Interactions Can Vary Person to Person

From anaesthetist.com:

In different people and different populations, activity of CYP oxidases differs. Genetic variation in a population is termed ‘polymorphism’ when both gene variants exist with a frequency of at least one percent. Such differences in activity may have profound clinical consequences, especially when multiple drugs are given to a patient. There are profound racial differences in the distribution of various alleles – data on a drug that works in one way in one population group cannot necessarily be extrapolated to another group.

Basically, that means that my cytochrome P450 cherry pickers don’t look or behave the same way as your CYP450 cherry pickers. Also, our cherry pickers might not move at the same speeds. These individual differences make predicting drug interactions difficult.

Gene Expressions Differ Causing Different Risks

According to this 2011 research study, the most important CYP450 isoforms metabolizing CBD are CYP3A4 and CYP2C19. This 2005 study shows that Zoloft also utilizes CP2C19. According to Anaesthetist.com, CYP2C19 is polymorphic. Different expressions of CYP2C19 may explain why some patients report negative side effects when taking Zoloft and weed.

Can An Interaction Be Deadly?

Internet stories abound, detailing patients’ scary experiences after combining anti-depressants and weed. Many of these users describe what sounds like severe panic attacks. Panic attacks are a possible side-effect of both Zoloft and marijuana.

NO Evidence of Fatal Reactions

Again – There is NO research or clinical evidence that a drug interaction with marijuana can be deadly. However, caution should still be utilized.

High levels of Zoloft in the blood can cause serotonin syndrome, a potentially fatal (but easily treated) side effect of many antidepressants.

Conclusion: Should I stop smoking weed?

That’s a personal question only you can answer.

Is your life at risk? Most likely no, many people function perfectly well taking both antidepressants and marijuana. Most patients never report negative experiences.

Still, our research into cannabis is limited. We expect to uncover more about risks and side-effects as we explore this new branch of medicine. Until then please research and understand the side-effects of your prescription medication and use cannabis cautiously.

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